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General NPI Number Information
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NPI Number | 1245840024
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Entity Type | Individual
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Provider Name | DESIREE DAVIS
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Gender | Female
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Dates
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Enumeration Date | 08/05/2020
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Last Update Date | 08/16/2024
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Provider Practice Location Address
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Address Line | 6681 RIDGE RD STE 300
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City | PARMA
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State | OH
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Zip | 44129-5705
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Country | US
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Telephone | 330-668-6785
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Fax |
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Provider Business Mailing Address
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Address Line | 7923 HOY CT
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City | CINCINNATI
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State | OH
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Zip | 45231-3315
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Country | US
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Telephone | 513-393-1798
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | LE-00033452
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APRN.CNP.0027523
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License Number State | OH
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